{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:48:32Z","timestamp":1790707712977,"version":"4.1.0"},"reference-count":6,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000589","name":"Chief Scientist Office","doi-asserted-by":"publisher","award":["15\/NS\/0101"],"award-info":[{"award-number":["15\/NS\/0101"]}],"id":[{"id":"10.13039\/501100000589","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current guidelines document persistent rectal bleeding as an alarm symptom in patients presenting to primary care. We studied whether a faecal immunochemical test could assist in their assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From December 2015, faecal immunochemical tests were routinely available to primary care when assessing patients with new-onset bowel symptoms: general practitioners were encouraged to include faecal haemoglobin concentration (f-Hb) within any referral to secondary care. Results with f-Hb \u226510\u2009 \u03bcg Hb\/g faeces were defined as positive. The incidence of significant bowel disease (SBD: colorectal cancer [CRC], higher-risk adenoma [HRA: any \u22651\u2009cm, or three or more] and inflammatory bowel disease [IBD]) at subsequent colonoscopy, referred symptoms and f-Hb were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1447 patients with a faecal immunochemical test result and colonoscopy outcome, SBD was diagnosed in 296 patients (20.5%; 95 with CRC, 133 with HRA, and 68 with IBD). Four hundred and sixty-two patients (31.9%) reported rectal bleeding: 294 had f-Hb \u226510\u2009 \u03bcg Hb\/g faeces. At colonoscopy, 105\/294 had SBD versus 14\/168 with rectal bleeding and f-Hb &lt;10\u2009 \u03bcg Hb\/g faeces ( P\u2009&lt;\u20090.0001), comprising one case of CRC (0.6%), 12 HRA (7.1%) and one new case of IBD (0.6%); further, the single cancer and 8 of the 12 HRA were located in the descending colon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with rectal bleeding and f-Hb &lt;10\u2009 \u03bcg Hb\/g faeces are unlikely to have SBD and could be investigated by sigmoidoscopy alone. Using the faecal immunochemical test to guide investigation of patients with rectal bleeding is a rational and practical way forward.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004563220935622","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T23:23:35Z","timestamp":1591053815000},"page":"325-327","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Measurement of faecal haemoglobin with a faecal immunochemical test can assist in defining which patients attending primary care with rectal bleeding require urgent referral"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-8734","authenticated-orcid":false,"given":"Jayne","family":"Digby","sequence":"first","affiliation":[{"name":"Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A","family":"Strachan","sequence":"additional","affiliation":[{"name":"Department of Blood Sciences, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"McCann","sequence":"additional","affiliation":[{"name":"Department of Blood Sciences, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert JC","family":"Steele","sequence":"additional","affiliation":[{"name":"Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1333-7994","authenticated-orcid":false,"given":"Callum G","family":"Fraser","sequence":"additional","affiliation":[{"name":"Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Mowat","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Ninewells Hospital and Medical School, Dundee, Scotland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,13]]},"reference":[{"key":"bibr1-0004563220935622","unstructured":"National Institute for Health and Care Excellence. NICE Guideline NG12; Suspected cancer: recognition and referral, www.nice.org.uk\/guidance\/ng12 (2017, accessed 9 November 2019)."},{"key":"bibr2-0004563220935622","unstructured":"National Health Service Scotland. Scottish Referral Guidelines for Suspected Cancer http:\/\/www.cancerreferral.scot.nhs.uk\/ (accessed 9 November 2019)."},{"key":"bibr3-0004563220935622","unstructured":"National Institute for Health and Care Excellence. NICE Diagnostic Guidance DG 30, Quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care, www.nice.org.uk\/guidance\/dg30 (2017, accessed 9 November 2019)."},{"key":"bibr4-0004563220935622","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0944-z"},{"key":"bibr5-0004563220935622","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2019-000293"},{"key":"bibr6-0004563220935622","doi-asserted-by":"publisher","DOI":"10.1177\/0004563219839423"}],"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563220935622","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0004563220935622","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563220935622","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:14:21Z","timestamp":1777378461000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0004563220935622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1177\/0004563220935622"],"URL":"https:\/\/doi.org\/10.1177\/0004563220935622","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]}}}